Lean six sigma

INTRODUCTION: Lean, especially Value Stream Mapping is increasingly used in hospitals to optimize processes. This method, which originated in the automotive industry, enables all staff involved in the process to make it more customer-friendly. Despite the widely reported success of Lean projects, they have failed in some cases. This study investigated the contextual factors and mechanisms that contribute to a successful implementation of Value Stream Mapping. METHODS: Value Stream Mapping was applied to the discharge process in four breast cancer centers...

OBJECTIVE: Breast imaging services often experience a significant degree of variability in patient flow, leading to delay in time to diagnostic resolution, commonly referred to as time to resolution (TTR). This study applies Lean Six Sigma Methodology (LSSM) to reduce TTR and enhance patient outcomes. METHODS: This study was IRB-approved. A baseline audit was done using cases of mammographic recalls (BI-RADS 0) to measure baseline TTR. Multidisciplinary meetings with all members of the breast imaging service, alongside a study of patient complaint data, were utilized to identify issues that were causing prolonged TTR...

Six Sigma Foundations is a statistical standard that indicates an exceptionally high level of quality, along with a customer satisfaction management approach that intends to lower error rates and boost process efficiency. The Define, Measure, Analyse, Improve, and Control (DMAIC) approach is a fundamental component of Six Sigma and provides an organised framework for process improvement. In contrast to conventional techniques that are more manual-based, Six Sigma emphasises and focuses on making decisions based on facts and evidence...

Laparoscopic cholecystectomy (LC) is the gold standard technique for gallbladder diseases in both emergency and elective surgery. The incidence of the disease related to an increasingly elderly population coupled with the efficacy and safety of LC treatment resulted in an increase in the frequency of interventions without an increase in surgical mortality. For these reasons, managers implement strategies by which to standardize the process of patients undergoing LC. Specifically, the goal is to ensure, in accordance with the guidelines of the Italian Ministry of Health, a reduction in post-operative length of stay (LOS)...

INTRODUCTION: Urgent endovascular intervention is currently accepted as the primary and critical therapeutic approach to patients whose acute ischemic stroke results from a large arterial occlusion (LAO). In this context, one of the quality metrics most widely applied to the assessment of emergency systems performance is the "door-to-puncture" (D-P) time. We undertook a project to identify the subinterval of the D-P metric causing the most impact on workflow delays and created a narrowly focused project on improving such subinterval...

BACKGROUND: Antimicrobial resistance (AMR) is one of the key challenges in healthcare, and effective antimicrobial stewardship programs (ASPs) can play a vital role to control it. The aim of the current study was to assess the impact of the Lean Six Sigma (LSS) methodology on a hospital-wide ASP. METHODS: This retrospective descriptive study was conducted at Mediclinic Welcare Hospital (MWEL), Dubai, the United Arab Emirates (UAE). The critical-to-quality (CTQs) data were collected pre/post interventions, including leadership support, guideline implementation, and audits...

OBJECTIVES: This work aims to improve the quality of care provided to patients by equipping caregivers with comprehensive set of problem-solving tools and competencies. This is achieved through the development of a customized health design process that incorporates both human-centric and data-centric tools. BACKGROUND: To meet the growing complexity of today's clinical practice, caregivers need to be empowered with the tools and competencies necessary to address the multifaceted challenges they encounter...

OBJECTIVE: The aim of this study was to report the authors' experience developing a Lean Six Sigma clinical care pathway (CCP) for endoscopic endonasal transsphenoidal operations. METHODS: Using Lean Six Sigma quality improvement principles-including the define, measure, analyze, improve, and control framework-the authors developed a CCP for endoscopic endonasal transsphenoidal operations, incorporating preoperative, intraoperative, and inpatient and outpatient postoperative phases of care...

This research investigates the requirement for and relationship and implementation of a total productive maintenance (TPM) and Reliability Centred Maintenance (RCM) strategy within an Active Pharmaceutical Ingredient (API) Plant. This research aimed to study the tools and techniques of TPM and Reliability Engineering and then deploy a designed model to an API plant. A case study involving Design for Lean Six Sigma phases of Define, Measure, Analyse, Design, and Verify was utilised to build an API site TPM pilot program...

In Ireland, the extent of outpatient orthopedic waiting lists results in long waiting times for patients, delays in processing referrals, and variation in the consultant caseload. At the study site, the Define, Measure, Analyze, Improve, and Control (DMAIC) Lean Six Sigma framework was applied to evaluate sources of Non-Value-Added (NVA) activity in the process of registering and triaging patients referred to the trauma orthopedic service from the Emergency Department. A pre- (October-December 2021)/post- (April-August 2022) intervention design was employed, utilizing Gemba, Process Mapping, and the TIMWOODS tool...

Economical, highly robust, selective, precise, and eco-friendly RP-UPLC and spectrophotometric methods were developed and validated for the concurrent estimation of selected pharmaceutical drugs represented in ceftazidime (CFZ) and pyridine (PYD) in their solutions using Agilent Zorbax SB-C18 RRHD (50 × 2.1 mm, 1.8 μm) column at flow rate 0.3 mL/min with wavelength 254 nm. Box-Behnken design (BBD) established Response surface methodology (RSM) to achieve the optimum chromatographic condition with minimal trials conducted...

PURPOSE/OBJECTIVE(S): Culture is a key factor in maintaining high-quality care. We have instituted a series of mutually-reinforcing initiatives aimed to improve operations, and patient and staff safety. We herein review the impact of these initiatives on our Patient Safety Culture over 14 years. We hypothesize that these initiatives can lead to sustained improvements in Culture. MATERIALS/METHODS: In ≈ 2009, our department, with help of dedicated quality improvement coaches from our internal Division of Healthcare Engineering (with knowledge of Lean-Six Sigma and High Reliability methods and tools), instituted (and largely sustained) initiatives aimed to improve our operations, and to improve patient/staff safety; including: (a) daily multidisciplinary team huddles, (b) daily pre-planning/treatment peer review, (c) a robust Incident Learning System, (d) weekly meetings to review reported incidents, (e) monthly department-wide meetings to review the highlights from the weekly incident review meetings, (f) celebration/recognitions for staff participation and (g) leader Gemba walks...

BACKGROUND: The purpose of this process and quality improvement activity was to address opportunities identified with cleaning, disinfection, and sterilization requirements for eye devices, and implement a robust and sustainable processing system to support safe patient care. METHODS: Through Lean Six Sigma methodology the evaluation of non-critical, semi-critical and critical device processing was conducted. A hierarchal approach to law, regulation, manufacturer's instructions for use (IFU), evidence-based guidelines, consensus documents, facility risk assessments, policy, and procedure was conducted...

Operating room (OR) management is a complex multidimensional activity combining clinical and managerial aspects. This longitudinal observational study aimed to assess the impact of Six-Sigma methodology to optimize surgical instrument sterilization processes. The project was conducted at the operating theatre of our tertiary regional hospital during the period from July 2021 to December 2022. The project was based on the surgical instrument supply chain analysis. We applied the Six Sigma lean methodology by conducting workshops and practical exercises and by improving the surgical instrument process chain, as well as checking stakeholders' satisfaction...

BACKGROUND: Outpatient clinic letters are recognized as an important component of patient care. This project aimed to coproduce clinic letters that have meaning and relevance for key stakeholders. METHODS: This health care improvement project was conducted in one musculoskeletal therapy (physiotherapy and osteopathy) department in southern England using a Lean Six Sigma Define, Measure, Analyze, Improve, and Control-inspired framework. The views and experiences of key stakeholders, including therapists, general practitioners, and patients, were explored using surveys and group meeting methods...

The purpose of this study was to determine the preference of employees for Lean Six Sigma project coaching attributes. Conjoint analysis with an orthogonal design was utilized and six attributes were considered: coaching style, frequency of coaching sessions, duration of coaching sessions, the turn-around time of feedback, documentation review, and mock defense. In addition, 4 different projects were also evaluated: Quick Win project, Yellow Belt project, Green Belt project, and Black Belt project. The results showed that for Quick Win projects, employees consider conducting a mock defense as the highest preference, followed by having a documentation review, and a democratic coaching style...

OBJECTIVES: to describe the Lean Six Sigma implementation process to improve the discharge process in a Brazilian health institution's ICU. METHODS: prospective study following the Define-Measure-Analyse-Improve-Control project development method. This method consists of five phases, namely: project definition, measurement of the starting point and data collection, analysis of results, improvement in processes, and statistical control. RESULTS: applying Lean Six Sigma methodology following the Define-Measure-Analyse-Improve-Control in the discharge process from the intensive care unit to the inpatient unit was effective in improving processes...

This paper presents the preliminary findings of developing and evaluating a Lean Six Sigma (LSS) e-learning aimed at empowering healthcare professionals in different roles to make healthcare more sustainable. The e-learning was developed with experienced trainers and LSS experts by combining traditional LSS and environmental practices. Participants found the training engaging and confirmed they felt motivated and prepared to start applying the acquired skills and knowledge. We are now following the 39 participants to further investigate the effectiveness of LSS for mitigating the climate challenge in healthcare...

Objective To increase compliance with Abnormal Involuntary Movement Score (AIMS) documentation for patients taking antipsychotics to recognize and treat tardive dyskinesia in the psychiatry outpatient clinic. Methods The Lean Six Sigma quality improvement (QI) model, utilizing DMAIC steps of define, measure, analyze, improve, control, was followed. Psychiatry attendings and residents were surveyed to assess reasons for AIMS non-documentation, and they ranked their preferred solutions to increase compliance...

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